The last man standing is the most resistant: eliminating artemisinin-resistant malaria in Cambodia.
The last man standing is the most resistant: eliminating artemisinin-resistant malaria in Cambodia.
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DOI：
10.1186/1475-2875-8-31
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发表时间：
2009-02-20
期刊：
影响因子：
3
通讯作者：
White LJ
中科院分区：
文献类型：
--
作者：
Maude RJ;Pontavornpinyo W;Saralamba S;Aguas R;Yeung S;Dondorp AM;Day NP;White NJ;White LJ
青蒿素综合疗法现在是全世界推荐的治疗恶性疟疾的一线疗法。消灭疟疾的举措在很大程度上取决于其效力。最近有令人担忧的证据表明，泰柬边境出现了青蒿素耐药性。紧急遏制干预措施已计划并即将执行。干预设计的数学建模方法现已纳入疟疾流行病学和控制领域。使用这样的方法来调查不同的遏制措施，最终目的是消除青蒿素耐药性疟疾的可能有效性进行了说明。开发了一个人口动态数学建模框架，以探讨在柬埔寨西部消除青蒿素耐药性疟疾的各种遏制干预措施的相对有效性。消除青蒿素耐药性疟疾的最有效干预措施是从青蒿素单药治疗改为青蒿素综合疗法（消除的平均时间为3.42年（95% CI 3.32-3.60年））。然而，采用这种方法，预计只有消灭所有疟疾，才能用青蒿素综合疗法消灭对青蒿素有抗药性的疟疾。这是因为各种形式的青蒿素综合疗法对青蒿素敏感的寄生虫感染更有效，使抗药性更强的感染在不断减少的寄生虫种群中所占比例越来越大。通过使用青蒿素综合疗法在柬埔寨西部消灭疟疾，可以遏制对青蒿素有抗药性的疟疾。“最后一个站着的人”是抵抗力最强的，因此必须坚持这一战略，直到真正实现消灭。
Artemisinin combination therapy (ACT) is now the recommended first-line treatment for falciparum malaria throughout the world. Initiatives to eliminate malaria are critically dependent on its efficacy. There is recent worrying evidence that artemisinin resistance has arisen on the Thai-Cambodian border. Urgent containment interventions are planned and about to be executed. Mathematical modeling approaches to intervention design are now integrated into the field of malaria epidemiology and control. The use of such an approach to investigate the likely effectiveness of different containment measures with the ultimate aim of eliminating artemisinin-resistant malaria is described. A population dynamic mathematical modeling framework was developed to explore the relative effectiveness of a variety of containment interventions in eliminating artemisinin-resistant malaria in western Cambodia. The most effective intervention to eliminate artemisinin-resistant malaria was a switch of treatment from artemisinin monotherapy to ACT (mean time to elimination 3.42 years (95% CI 3.32–3.60 years). However, with this approach it is predicted that elimination of artemisinin-resistant malaria using ACT can be achieved only by elimination of all malaria. This is because the various forms of ACT are more effective against infections with artemisinin-sensitive parasites, leaving the more resistant infections as an increasing proportion of the dwindling parasite population. Containment of artemisinin-resistant malaria can be achieved by elimination of malaria from western Cambodia using ACT. The "last man standing" is the most resistant and thus this strategy must be sustained until elimination is truly achieved.
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影响因子：
3
作者：
Incardona, Sandra;Vong, Sirenda;Fandeur, Thierry
通讯作者：
Fandeur, Thierry
影响因子：
3.3
作者：
Denis, Mey Bouth;Tsuyuoka, Reiko;Ringwald, Pascal
通讯作者：
Ringwald, Pascal
DOI：
10.1073/pnas.94.17.9389
发表时间：
1997-08-19
影响因子：
11.1
作者：
Rathod, PK;McErlean, T;Lee, PC
通讯作者：
Lee, PC
DOI：
10.4269/ajtmh.2007.77.193
发表时间：
2007-12-01
影响因子：
3.3
作者：
Bosman, Andrea;Mendis, Kamini N.
通讯作者：
Mendis, Kamini N.
影响因子：
3.3
作者：
Denis, Mey Bouth;Tsuyuoka, Reiko;Ringwald, Pascal
通讯作者：
Ringwald, Pascal